Voxel-based and surface-based cortical morphometric MRI applications for identifying the epileptogenic zone: A narrative review

Abstract

Approximately 40% of patients with drug-resistant epilepsy referred for surgical evaluation have no epileptogenic lesion on MRI (MRI-negative). MRI-negative epilepsy is associated with poorer seizure freedom prognosis and has therefore motivated the development of structural post-processing methods to “convert” MRI-negative to MRI-positive cases. In this article, we review the principles, advances, and challenges of voxel- and surface-based cortical morphometric MRI techniques in detecting the epileptogenic zone. The ground truth for the presumed epileptogenic zone in imaging studies can be classified into lesion-based (MRI lesion mask or histopathology) or epileptogenicity-based ground trut..